Tag: medical futility blog

Blog Posts (1468)

December 6, 2016

Here is a recording of Oliver Wendell Holmes commenting about death in 1931 on his 90th birthday. He retired from the court just a few weeks later. "In this symposium my part is only to sit in silence. To express one’s feelings as the end draws near is too intimate a task. But one thought that comes to me as a listener-in. The riders in the race do not stop short when they reach the goal. There is a little finishing canter before coming to a standstill. There is time to hear the kind voice of friends and to say to oneself that the work is done.""But just as one says that, the answer comes: The race is over, but the work never is done while the power to work remains. The canter that brings you to a standstill need not be only coming to rest. It cannot be while you still live, but to live is to function. That is all there is. And so I end with a line from a Latin poet, who uttered the message more than fifteen-hundred years ago, Death, death, plucks my ear, and says, ‘Live. I am coming.'" (HT: John Blackman)

December 5, 2016

For three years, the family
of Jahi McMath has made numerous public claims that she is alive.

The medical defendants in her malpractice lawsuit now want to rebut those
claims by using evidence presented during hearings in December 2013. But
those records are under seal. The family opposes
the defendants' joint motion, citing Jahi's right to confidentiality.
A hearing is scheduled for December 13, 2016.

Furthermore, for those wanting to "catch up" on what this case is all
about, the plaintiffs’ opposition brief provides a nice recap of the medical
malpractice claims. It also provides a recap of the evidentiary basis
that Jahi is now alive. Highlighting is mine.

"Here, based upon
medical experts' evaluations of Jahi since Judge Grillo's ruling in 2013, she
no longer fulfills standard brain death criteria, due to her ability
to specifically respond to stimuli. The distinction
between random cord-originating movements and true responses to command is
crucial to diagnosis of brain death. Jahi is capable of intermittently
responding intentionally to a verbal command."

"Additionally, the
international team of medical experts who gathered to observe, test and
analyze Jahi's unprecedented progress in the fall of 2014 saw evidence of brain
activity in the EEG. They observed the brain activity increase and become
'readily identifiable and profound' when Jahi's mother spoke to Jahi.
A long and thorough MRI was conducted in which they 'unequivocally saw
the presence of brain structure including the evidence of ribbons in the brain."

"This is critical as it showed that the brain, although damaged, was there
structurally.' Nine months after Jahi was declared brain dead, the
experts 'would have expected to see her brain had liquefied. It clearly was
not.' Additionally, the experts looked for evidence of blood flow. 'Blood
flow was clearly evident. This does not happen if a patient is brain dead.'"

"In
overruling Defendants' demurrer to Plaintiffs' personal injury claim, this
Court has properly rejected Defendants' argument that once their physicians
opined in December 2013 that Jahi was brain dead for the purpose of removing
life support, her death became static, fixed and permanent, and Jahi is
absolutely precluded from alleging and proving that she is, in fact,
alive."

"To the contrary, her
condition has changed dramatically since Judge Grillo's
ruling in December 2013 - among other changes, there are vast areas of
structurally and relatively preserved brain, tests demonstrate intracranial
blood flow consistent with the integrity of the MRI and inconsistent with brain
death, and Jahi underwent menarche (her first ovulation cycle) and began breast
development."

Legal Compliance Essentials for Drug, Device, and Biotech Companies

The Compliance Certification Board (CCB)® has approved this event for up to 10.8 CCB CEUs. Continuing Education Units are awarded based on individual attendance records. Granting of prior approval in no way constitutes endorsement by CCB of this program content or of the program sponsor

Faculty

The U.S. health care system is composed of three primary parts: providers, payers, and finally manufacturers (drug, device, and biotech companies). It is a complex, complicated, and challenging system of laws, regulations, cases, guidance and, in some cases, folklore. This course is designed for the current and future attorney or compliance professional supporting drug, device, and biotech companies. Students will gain a practical understanding of the laws, regulations, cases, and guidance they will encounter in daily practice. Also, upon completion, all participants will understand how to design and operate an effective company compliance program.

From Addiction to Zika: Current Issues in Public Health Law

Description

This course explores public health law through the lens of current issues in population health. Prescription drug overdose and the zika virus have captured the attention of both policy-makers and the public, as have topics such as gun violence, obesity, access to care, vaccine refusal, medical marijuana, and smoking. We will examine the leading causes of preventable death, disease, and injury, both in and out of the spotlight. Students will analyze the underlying social, economic, and environmental factors that contribute to or detract from community health and well-being, as well as legal strategies to address those factors. In the process, the course introduces students to the fundamentals of public health law, including those constitutional, statutory, and administrative laws that empower or mandate government to act to advance community health and those that curtail governmental power to do so.

Textbook

Required: Readings will be made available either through a bound supplement for sale in the bookstore, or through links on Blackboard.

December 4, 2016

Last month, the Virginia Joint Commission on Health Care decided not to move forward on specific proposals to amend the state Health Care Decisions Act.
If enacted, the VJCHC proposals would have made Virginia law similar to Texas law, by autho...

December 1, 2016

Presentations from the 2016 Critical Care Forum are now posted to the website.
These include two by Bernat on brain death, one by Rubenfeld on the Rasouli case, and others on intensivist variability and end-of-life care.

November 30, 2016

Here is a superb overview video on the medical and philosophical aspects of brain death. James L. Bernat, professor of Neurosicence at Dartmouth, delivered this lecture in Barcelona at the Víctor Grífols i Lucas Foundation on November 15, 2016.

November 29, 2016

Texas Right to Life has announced its legislative priorities for the 85th Texas legislative session that begins on January 10, 2017.
Not surprisingly, this agenda includes a repeal of the dispute resolution provisions in the Texas Advance Directi...

November 29, 2016

Texas Right to Life has announced its legislative priorities for the 85th Texas legislative session that begins on January 10, 2017.
Not surprisingly, this agenda includes a repeal of the dispute resolution provisions in the Texas Advance Directi...